Sunday, August 30, 2009

Loki's fever is ongoing, unfortunately. However, so are his generally good mood and impressive development. Loki started bearing weight on all fours, rocking back and forth on arms and knees. He now constantly bangs to toys together or bangs them on the table. Yesterday when I offered him a cracker for his right hand, which was already holding on to a rattler, he switched the rattler to his left hand after which he grabbed the cracker with his right hand. Pretty complex problem solving for such a tiny man, if I may say so!?

Current weight is 15 lbs and 7 oz, which brings our little guy at approximately the 35th percentile for weight, and almost 80th percentile for weight with length on the preemie chart. Little guy needs to go on a diet before we know it. On the regular chart he still charts below the 5th percentile for a 7 month old.

We have had a good friend visit who brought Loki a bag full of goodies and super cute overalls, perfect for the extremely hot weather, and in addition to that we've just done our almost daily doctors visit to figure out what is causing this everlasting low grade fever. No teeth seem to be coming out, no clear other signs either. It's somewhat of a mystery which will most likely need further investigation. Possibly we will have to see the same infectious disease doctor that treated him when he was still at Alta Bates NICU.

Speaking about the NICU. September 17th I will have my first meeting with the Alta Bates NICU partnership council as a parent representative. I am very excited about this chance to "pay back" the NICU for helping us so tremendously well.

Also following soon is a invitation to participate in our Christmas Gift drive for the babies at the NICU during this upcoming Christmas. I would love to be able to brighten the day of all those parents during the challenging Christmas days with your help. The exact how and what are being worked on.

Finally, we are still unsure what will happen with feeding therapy for Loki. He will no longer qualify through the state, still infuriated about those new regulations, and it is unclear if the insurance will pay for therapy.

Some recent photo's of our ever growing miracle.

He loves sleeping on his tummy:

Loki was very excited to meet Auntie Sharon:

Silly boy, in one of his cool overalls, shying away from the camera:

Showing off his shaking skills:

Loki met his friends Finnie for the first time. Finn sings very cool Loki Artichoki songs and promised to teach Loki how to talk:

The London Underground Hat and Paddington were gifts from Finnie and his mom. Paddington is a very special gift as the little bear friend was bought in the nieghborhood of Paddington in London where Finnie was born:

Loki's head growth has never been a problem, pretty obvious on this picture:

Mom and Loki during an outing to the Oakland Chinatown festival around the corner from where we live:

Loki is wearing yet another overall, this one came from Lova and Muus' fashionable closet:

How about this cute one piece outfit from Cousi Nicole and her son Basje?

>Loki and his early interventionist Barbara, to whom we will have to say goodbye by the end of September (don't get me started on this again....)

Wednesday, August 26, 2009

The New York Times had an article yesterday about new research, which indicates that some parents exhibit symptoms of post-tramatic stress disorder (PTSD) after their time in the NICU. Mom had commented on the similarity months ago. I copied the article below, because the NYT site requires registration.

For Parents on NICU, Trauma May LastBy Laurie TarkanNew York TimesAugust 25, 2009

Kim Roscoe’s son, Jaxon, was born three months early, weighing two and a half pounds. But for nine days he did exceedingly well in the neonatal intensive care unit, and Ms. Roscoe felt little different from the other new mothers.

Her nightmare started on Day 10.

“I had left him late the night before, in my arms, tiny but perfect,” said Ms. Roscoe, now 30, of Monterey, Calif. But when she returned to the NICU the next day, Jaxon was in respiratory and kidney failure, and his body had swollen beyond recognition.

“He was hooked up to ventilators, his skin was turning black, the alarms kept dinging over and over,” Ms. Roscoe recalled.

Jaxon is 16 months old now, and home with his family. But he was in the NICU for 186 days, and his days and weeks were punctuated by near-death episodes.

During the six-month ordeal, Ms. Roscoe had constant nightmares. She slept with her shoes on, expecting a call from the hospital at any moment. She became angry at the world, and so jumpy she thought a supermarket scanner was one of Jaxon’s monitors going off. Her husband, Scott, immersed himself in projects, took care of their daughter, Logan, now 6, and held things together emotionally.

About three months after her son’s birth, Ms. Roscoe asked to see a psychiatrist. She was given a diagnosis of post-traumatic stress disorder, or P.T.S.D. — a mental illness more often associated with surviving war, car accidents and assaults, but now being recognized in parents of premature infants in prolonged intensive care.

A new study from Stanford University School of Medicine, published in the journal Psychosomatics, followed 18 such parents, both men and women. After four months, three had diagnoses of P.T.S.D. and seven were considered at high risk for the disorder.

In another study, researchers from Duke University interviewed parents six months after their baby’s due date and scored them on three post-traumatic stress symptoms: avoidance, hyperarousal, and flashbacks or nightmares. Of the 30 parents, 29 had two or three of the symptoms, and 16 had all three.

“The NICU was very much like a war zone, with the alarms, the noises, and death and sickness,” Ms. Roscoe said. “You don’t know who’s going to die and who will go home healthy.”

Experts say parents of NICU infants experience multiple traumas, beginning with the early delivery, which is often unexpected.

“The second trauma is seeing their own infant having traumatic medical procedures and life-threatening events, and also witnessing other infants going through similar experiences,” said the author of the Stanford study, Dr. Richard J. Shaw, an associate professor of child psychiatry at Stanford and the Lucile Packard Children’s Hospital.

“And third, they often are given serial bad news,” he continued. “The bad news keeps coming. It’s different from a car accident or an assault or rape, where you get a single trauma and it’s over and you have to deal with it. With a preemie, every time you see your baby the experience comes up again.”

Abby Schrader and her partner, Sharon Eble, delivered twins at 23 weeks. Both girls, born at 1 pound 5 ounces each, were having continuous near-death events. “We were constantly being asked whether we wanted to remove support,” said Ms. Schrader, of Philadelphia.

Eighteen days after the girls’ birth, the couple did withdraw support from one baby, whose health had badly deteriorated. The surviving twin, Hallie, now 3, was in the NICU for 121 days and continued to have medical problems once home. “From the moment of their birth, and still to this day, we feel like we’re triaging everything and just hanging on,” Ms. Schrader said.

The Stanford study found that although none of the fathers experienced acute stress symptoms while their child was in the NICU, they actually had higher rates of post-traumatic stress than the mothers when they were followed up later. “At four months, 33 percent of fathers and 9 percent of mothers had P.T.S.D.,” Dr. Shaw said.

It may be that cultural roles compel the men to keep a brave front during the trauma to support their partners, Dr. Shaw said, adding, “But three months later, when the mothers have recovered, that’s when the fathers are allowed to fall apart.”

The post-traumatic stress may take the form of nightmares or flashbacks. Sufferers may feel panic every time a beeper goes off in the intensive care unit, or they may avoid the trauma by not visiting the unit or by emotionally distancing themselves from their child. Over time, they may develop depression, anxiety, insomnia, numbness, anger and aggression. These symptoms, of course, can impair their abilities as parents.

Several studies have shown that the risk of P.T.S.D. was not related to how tiny or sick the child was or how long the stay in the NICU. “It had to do with the parents’ coping style,” Dr. Shaw said. “There were some who were more resilient and others more vulnerable.”

In one study of rural African-Americans, those who were at greater risk of post-traumatic stress reported more problems in their daily lives, like financial trouble or lack of a partner, said the study’s author, Diane Holditch-Davis, a professor at Duke University School of Nursing. One of the biggest problems for these parents is coping after they finally leave the NICU.

“It may be several months later when they’re ready to process what they experienced, but at that point, family and friends don’t want to talk about it anymore,” Dr. Holditch-Davis said.

Ms. Schrader, in Philadelphia, felt a similar isolation in dealing with her surviving daughter’s health problems. “We got the sense that people just didn’t want to hear about it anymore,” she said.

Experts say parents who are at risk for post-traumatic stress should be identified ahead of time and given help to prepare them for dealing with the initial trauma. But many hospitals are focused on saving the infants, not the emotional crises of the parents.

“Some hospitals have really great programs, and in some, it’s really very sad,” said Liza Cooper, director of the March of Dimes NICU Family Support program, which offers psychological support to parents in 74 hospitals nationwide. Even though most units have social workers, she went on, “there’s really no one there to support the parents, provide group activities or education.”

Vicki Forman did not realize that she was suffering from post-traumatic stress until about four years after the premature birth of her twins, when she began researching her book “This Lovely Life” (Mariner Books, 2009), about her experience in the NICU and raising her surviving son with multiple disabilities.

“What the parent is going through is more or less dismissed because what you’re contending with are the health issues of your child,” she said. “Occasionally a social worker will say, ‘Are you taking care of yourself?’ but never, ‘This is a traumatic experience you endured and you need to pay attention to these symptoms.’ ”

Some hospitals pair parents of premature babies in intensive care with those who have been through the experience. One study found that 16 weeks after childbirth, mothers who were matched with NICU veterans had less anxiety and depression, and felt they had more social support, than mothers in a control group.

In addition to the family support program, the March of Dimes runs an online support community called shareyourstory.org. “The most critical piece is to help prepare someone so they know what to expect and don’t fall into a world of frightening unknowns,” said Ms. Cooper, from the March of Dimes.

Untreated P.T.S.D. can have lingering effects on the child. During the NICU stay, for instance, traumatized parents may find it hard to hold or even look at their child, and that can profoundly affect the baby’s attachment to the mother. Later, mothers might experience “vulnerable child syndrome,” in which they become so anxious that a minor medical event sends them into a panic. Normal, everyday risks can seem life-threatening; children can learn to gain unhealthy attention from physical complaints.

In her book, Ms. Forman wrote: “From the moment my twins were born, I saw potential for tragedy wherever I turned. It would be years before I stopped thinking that way.”

In Monterey, Kim Roscoe is coping with a similar anxiety now, 16 months after Jaxon’s birth. “I still freak out if he has a runny nose,” she said. “And when he gets a fever, I’m back in the NICU.”

Sunday, August 23, 2009

Unfortunately our little guy continues to have his weird low grade fever. He has had it for a little over a week, with a two day break. The Doctors are somewhat clueless about what is going on, but all agree that they do not like to see this pattern.

Since Loki was discharged from the hospital we have seen many doctors and nurses, lots of trips to hospitals and several pokes and prods.

Just to give you an idea of the last two weeks:*Monday the 10th (if I remember correctly) we saw Dr. Abbott in his office and OT Heather for feeding therapy at our home.*Tuesday the 11th we spent approximately 6 hours total to get to UCSF hospital and have a MAG3 Scan (still no results as we need to visit the urologist to know if and what they found). This scan by the way, was absolutely awful. Loki was strapped to a bed with sand bags next to him and a bunch of blankets wrapped around him. Then tape was strapped around him and the blankets so he could not move. Only one arms was free to use, because the other arm had an IV (which took a while and several pokes to put in). He was laying down and crying continuously for almost 1.5 hour. Very, very sad little boy. I read books, sang songs, stroked his head and gave kisses. Nothing could comfort our little guy.*Thursday Home Health nurse Elizabeth, who lived in the Netherlands for five years, came to check in on Loki.*Friday Loki had cranial sacral therapy at home, in the evening the fever was first noted.*Saturday we saw Dr. Vo at our pediatrician's office.*On Monday we saw Dr. Vo again because of the fever and she sent us to Children's Hospital Oakland for X-rays of his chest and abdomen. Besides the feeding tube being in too far and minor upper respiratory congestion nothing came up. No explanation of the low grade fever.*Tuesday family visit from Uncle Jan and his family. No Doctors, yeah!*Wednesday we had early intervention from Barbara cut short for yet another Doctors visit. Still fever, still no clear explanation. We were sent to Children's Hospital again to get blood work done. Urine checked as well, it looked clear. The nurse, although friendly, was rough and Loki ended up with a half draw on the left, big bruises and a full tube of blood via the left arm. The only significant outcome? Bicarbonate of 3o. Normal range is usually 20-28, however this depends on which test is used. Nobody is too concerned, yet a little confused. This could indicate that the kidney is not processing perfectly well, but no worries they say. Another draw in a few weeks to follow progress.*Thursday GI visit with Dr. Rhee at UCSF. She has no idea about the low grade fever, which seemed to be gone for the day, despite a somewhat high baseline temperature. She wants a stool sample as I (mom) noticed somewhat odd white curds in Loki's stool. Seriously, how many parents out there extensively explore their child's urine and stool? Fortunately more than once it has gotten Loki the help he needed rather fast.*Friday, mom had Doctors visit, blood draw etc. just to have a standard check of her one kidney (per advice of Loki's nephrologist. Just once a year to be sure all is well.) Stopped by Pediatrician's office to get jars for stool samples. In the evening OT for Loki and lucky enough, a break for mom and dad. Loki's wonderful OT had offered to babysit our little guy so we could go out for Sushi and a soak in the hot tub at Piedmont Springs, Very nice to drop parenting duties for a few hours. Heather is yet another angel in our lives and Loki loves her. He is very smiley with her, and when being held he nestles himself in her arms. Very, very cute.*Saturday Loki pooped, yahoo. Scooped stool in two jars from the diaper. WOW.... never read poop scooper was part of job description motherhood! Drive to Berkeley to drop off poop at lab.

That's where we are at today.... Loki's low grade fever is back... pfff. We know we will see the Doctor again upcoming week as it is not normal for a baby to have a fever more than a few days, without something brewing in the background. The little guy is in a good mood though and playing happily with his maracas trying to bang them together or taking his shapes out of a jar.

Everyday I spend at least 30 minutes, and sometimes up to 1.5 hr. on the phone with Doctors, therapists and nurses to either set up appointments, discuss progress or lack there off and share info shared by the other providers with me, but which they do not necessarily share with one another. In addition Loki pulls his tube partially out frequently and completely out every three days or so. We're so much quicker and much more comfortable putting it back in though.

It is quite a lot, juggling all these different doctors and service providers with their sometimes bureaucratic offices and telephone lines. Nevertheless, when I woke up this morning I felt so blessed with Loki in my life and dad as such a wonderful husband and dad to Loki. I realized how much more complete I feel having Loki join us in this crazy world. Despite all his procedures and medical appointments he is so happy and easy going. He babbles, laughs, plays and cuddles most of the time. Cries very little and treats us with the sweetest giggles when we kiss his tummy or neck. In the end that makes the medical treadmill bearable. This wondrous, curious, handsome and sweet little man of ours!

Wednesday, August 19, 2009

Loki is 10 months old (chronological) and this is the wonderful birthday gift he received! We love Annette and Janet (order of appearance, left to right). Room 3 was Loki's room from Day 1, and then for quite a while:

Oom Jan (Mom's uncle) visited today with his son David and wife Aimee (hoped to have a picture with Aimee from her camera, mine are mostly blurry!!):

Cuddling with Mom's cousin David:

Sitting up for 10 minutes at a time now, playing freely with his hands:

Just pretending to drink and eat:

Daddy loves his punky boy:

Oh, how handsome:

With Daddy in the swimming pool:

Prepping for the pool:

Monkey butt:

Today I am 10 months old:

The following were taken by Mascha at our pool day on Saturday. Yes, three of these are repetitive. But they are great shots!

Sunday, August 16, 2009

Loki appears to be a bit sick. He has had a very mild fever on and off, and his energy level is a bit low. His breathing is sometimes quite strained and raspy. Mom took him to the doctor, and we need to watch him closely. If he still has a low fever Sunday evening, then he goes to the doctor Monday morning.

There is a potential ironic upside to being sick: He needs to gradually strengthen his immune system by being exposed to various germs. This will sometimes include getting sick. Thus, a mild illness may be a good thing, overall.

Loki continues to grow and develop rapidly. Today he is 14 lbs 6 oz (6.52 kg), and is adding about 9 ounces each week. Today he was able to bear more weight while trying to lift his stomach up and be on all four limbs. He also rolled over a bunch in bed. He can sit up and rest his the weight of his upper body forward onto his straight arms. Best of all, he is falling asleep on his own--usually within 15 minutes, with some crying.

This is all good, but we ran into a problem. He was crying in bed, and we let him go for a few minutes, perhaps allowing him to fall back asleep. When he didn't stop crying, I went in to check on him. His feeding tube (which was connected to the pump) was wrapped around his neck. He was struggling a bit to breathe.

Obviously, we need to do something about this. We put his tube under his shirt, taped at its bottom, through a small hole that I cut in the middle of his bed sheet, under and out the sheet, then to the pump. This seems to be the position with the least likelihood of getting wrapped up. We will also buy a video monitor tomorrow.

Loki's MAG3 scan of his kidney was Tuesday. It was very unpleasant for Loki. He got an IV and was strapped down for 90 minutes, crying loudly the whole time. We haven't heard any results. But bad news travels fast, so we don't worry.

Loki goes to the gastroenterologist on Thursday. Perhaps we can learn more then.

Our medical insurance may cover his feeding therapy. If it is considered a medically-caused (and not behaviorally-cased) food aversion, then it should be included. Keep your fingers crossed.

We are able to have a bit of fun. Mom has taken Loki swimming for several afternoons. Today we had some friends over. Although Loki did not swim, he had fun with our guests, particularly little 4 year old Anna. He sat on her lap and sort of "played" with her. Very cute.

We are planning a week vacation in September to Santa Catalina Island off the coast of Los Angeles. Obviously, we are very much looking forward to this. But also, I, for one, am a bit nervous. We have never even driven more than an hour with Loki, much less fed on the road and stayed in hotels. This is seven hours of driving, then a ferry. And we'll need to transition to a nearly-totally formula diet. We can't take frozen breast milk. Our hotel on the island, though, is quite friendly and accommodating.

Thursday, August 13, 2009

Been awake for quite a bit last night thinking about the budget cuts and new eligibility criteria for early intervention services in the state of california. Yes I know california is spelled with a capital C, governor with a G and sacramento with an S, just not deserving it right now! ..... makes me sick, sad, angry and certainly makes me want to swear so loud they can hear me in sacramento. Seeing my beloved early intervention field go down the drain is not anything I had ever imagined!!!! The fact that Loki no longer qualifies for feeding therapy is frustrating and ridiculous. He does not eat by mouth yet this is not considered a delay in adaptive skills…..?. However, thinking about thousands and thousands of kids who will end up in the school system with delays because they do not qualify for infant development services due to absurd new eligibility criteria makes me profoundly angry.

WHAT ARE THEY THINKING? How are all those micro preemies going to catch up without help? How are those little ones 0-2 with yet to identify syndromes/disorders (and believe me, there are quite a few) going to be helped if the child has a delay in all domains just not quite at 33%? How are prenatally drug exposed children with their often a-typical development going to be supported? At 24 months children need to show a 50% delay in any or more of the developmental domains (i.e. social-emotional, self help/adaptive, language and speech, gross motor, fine motor or cognitive development) in order to qualify. Seriously? Can you imagine hearing this “sorry your son does not qualify for services, his language and cognitive development only show a delay of 40%, that’s not enough.”

I can guarantee you behavioral issues will rise and thus we’ll see more child abuse. Ever put 1 and 1 together? School districts are going to be overloaded, as if they were not already! I do not know what to say, or how to say it to even come close to addressing how angry I am about those budget cuts………….

Maybe a more eloquent and intelligent post later. For now my blood is boiling!!

Sunday, August 9, 2009

We have been home from the hospital for two weeks now. The tube has a lot of advantages and disadvantages. Loki has grown more in the last two weeks than in the previous two months. He is up to 13 pounds 9 ounces (6.15 kg). We also struggle much less with feeding him . We offer food, and if he refuses, then we move on to the tube and pump. It is also easier to share the work: Before, Mom was the only one who really knew how to feed Loki. Now I can do it just as well. And the other night Loki's Nurse Extraordinaire Margaret did us the huge favor of sitting Loki while we had our first real night out in almost a year. Loki was incredibly at ease with her, which made it very easy for us to leave and not worry during our almost seven hour adventure.

Of course, it is a constant task. Each three hour feeding cycle has a half-hour set up, then a one hour wait, then a fifteen minute take-down, then a 75 minutes wait for the next cycle to begin. We give him 105 mL (half thawed breast milk, half NeoCate formula, fortified to 24 cal / ounce) over an hour at each feeding.

However, we gave in, and are now trying continuous feeds overnight. If we didn't do that, we would not get enough sleep and just go crazy. So, every 3 hours from 9 AM until 10 PM, we do normal feeding. Then from midnight until 7 AM, we have the pump on continuously, providing three feedings worth of pure NeoCate. During the week we will give continues feeds only two feedings overnight.

Loki still struggles with the food. His reflux can be quite painful, and some nights and early mornings he wakes up quite a lot of discomfort. In addition he coughs, spits up and sometimes even aspirates (breathes in some refluxed milk) more often than in the past.

Suddenly today, Loki began to vocalize much more. He used to "talk," but largely stopped in the last couple months. Then today, he talks with lots of babbly sounds, like gah, dah, bah, and blah. He even does it when he's upset. Instead of screaming "Whaaaah!" he now screams with clear syllables. It's funny, in that it sounds like he is swearing.

For a week, my brother and his son - thus Loki's Uncle Brent and Cousin A.J. - visited. It's great for Loki to meet his family!

Our new apartment has a pool, and we finally went swimming yesterday. Loki tried a little boat, and this funny head floater ring that is popular in China, but not yet here. He had a lot of fun, particularly once he got the hang of the head float and realized he could kick around.

Loki babbles:

Loki swims:

Dad and little man:

With Uncle Brent:

With Cousin A.J.:

Loki, Uncle Brent, and Cousin A.J.:

Little boat:

Head floater:

With our friend Christine, who has been a huge help, particularly at the hospital:

Sunday, August 2, 2009

Home with the tube has been an interesting adventure so far. It is not surprising that Loki likes to pull the tube. He has done so completely two times, and almost all the way numerous times. He is minding his business, playing in the chair, rolling in his bed, angry in the bouncy seat and all of a sudden there it is..... the sound of coughing, gagging and sneezing. Sometimes we run over quick enough to prevent the tube from coming out all the way. Sometimes the little trickster is too fast with his little pinky finger hooked "safely" into the looped tube near his nose. Either way, we are in for some screaming and big hugs for consolation afterwords.

Putting the tube in has become "easier" and is still very challenging at the same time. Practically, I am getting the hang of it. Emotionally, it is far from a fun experience. It is very uncomfortable for Loki, especially when the loop keeps popping out in the mouth, rather than down the esophagus. It takes two people, a swaddled little prince, a tube, Tegaderm (tape to keep the tube in place), duoderm (skin protecting tape), stethoscope, syringe, alcohol wipe, and a whole lot of love, dedication and hugs. Best way to get the tape on? Lots of firm kisses on the cheek! Poor little guy turns red like a tomato from screaming his lungs out!

Although we are very relieved to know Loki's precious body is well nourished and his kidney well flushed, the actual schedule of the feedings is pretty draining, not in the least because Loki has gotten much more colicky again with the extra calories. He started on 27 calories per ounce of breast milk fortified with NeoSure. Basically, he had the same response he had in February. At our follow up appointment last Friday, we were sent home with Neocate. This has worked in the past, but for now Loki remains crampy and cranky overnight, with the wonderful side effect of little sleep for Dad and Mom. We are sharing the overnight duties and I am very grateful for that. Dad does have to go to work, but nevertheless unhooks the pump and cleans it out after the two overnight feedings. I change diaper, get milk warming and pump set up and then breastfeed (yes, it is the only oral intake at this point in time...???!!) before hooking Loki up to the pump. We have become pretty smooth, but we do not sleep more then two hours at a time, usually much less due to the cramps. WOW, we thought we had kinda been there.....

Daytime naps are much better. He actually sleeps between 45 minutes to 1.5 hour at least one time per day in his bed, after an initial 30 minutes in mom's arms. That is exciting!!

Loki is thriving well on the extra calories and already gained between 5 to 7 ounces, depending what scale to trust. He looks more sturdy and solid and is even more alert to his environment and when exploring toys.

Uncle Brent (Dad's brother) and Alexander (Loki's cool, almost 10 year old cousin) are visiting. It is very fun to have them around. Uncle Brent baby sat for a few hours Friday night, and tonight Alexander and I are going to the movies!!

On a less exciting note, due to budget cuts and crisis the field of early intervention is about to be hit very hard. If Department of Developmental Services is following through with their new proposals Loki and many other children will no longer receive services to ensure they catch up by the time they go to school. In Loki's case, I am not too worried (although agitated) because I happen to be an infant development specialist myself. However, the implication for thousands and thousands of other children is simply devastating. I also suspect that the eventual social and financial implication of this for California will be much more challenging than the DDS is able (or willing) to admit. Many problems will go unnoticed until children end up at school, when those extremely precious first years of brain development are missed.

About Loki Sky

Loki Sky is a special little man. He was a very early micropreemie, weighing only 610 grams (1 lb, 5 oz) after 24 weeks, 3 days gestation, born to an American Father and a Dutch Mother in Berkeley, California on October 18, 2008.

On January 11, 2009, while still in the hospital NICU, his one kidney stopped working. It was repaired after three surgeries. After spending time in three hospitals in three cities, Loki came home on February 17. He struggled with eating, and then stopped in July, leading to 8 days in the hospital, a failure-to-thrive diagnosis, and a NG feeding tube. On October 10, a minor surgery installed a G feeding tube. Another procedure replaced it with a new one, and then again with a Mic-Key button in Jan. 2010.